C. elegans as a Powerful Tool for Cancer Screening

Abstract

Regular cancer screening is critical for early cancer detection. Cancer screening tends to be burdensome, invasive, and expensive, especially for a comprehensive multi-organ check. Improving the rate and effectiveness of routine cancer screenings remain a challenge in health care. Multi-cancer early detection (MCED) is an exciting concept and a potentially effective solution for addressing current issues with routine cancer screening. In recent years, several technologies have matured for MCED, such as identifying cell-free tumor DNA in blood or using organisms such as Caenorhabditis elegans as a tool for early cancer detection. In Japan, N-NOSE is a commercially available multi-cancer detection test based on the chemotaxis of C. elegans using a urine sample showing 87.5% sensitivity and 90.2% specificity. In this review, we focus on using C. elegans as a powerful biosensor for universal cancer screening. We review N-NOSE clinical research results, spotlighting it as an effective primary cancer screening test.

Cancer Screening: Present Recommendations, the Development of Multi-Cancer Early Development Tests, and the Prospect of Universal Cancer Screening

“…It is important to mention that the N-Nose behavioral assay has been thoroughly evaluated in clinical studies with large cohorts of patients, showing reliable results. Also, the results have been replicated at other prestigious institutions in the US and Italy [ 7 , 128 , 198 , 199 , 200 , 201 , 202 , 203 ].…”

“…With the potential of multi-organ detection, we can imagine tests that can include all cancers in a single efficient modality of testing, which would be potentially both cost- and life-saving. Perhaps, in the era of treating cancer using “precision medicine” tailored to the most intimate characteristics of tumor cell biology, a “one test to rule them all” approach toward cancer screening would be a match made in heaven, as simulations have already modeled, promising reductions of up to a quarter in all cancer-related deaths in patients aged 50–79 years in the United States and a reduction of almost 80% for late-stage (III, IV) disease [ 7 , 17 , 205 ].…”

“…Such expenses warrant investments in MCED, as tests such as Galleri (~945 USD), or N-Nose (~109 USD) can be cheaper than PET-CT, for instance (~1100 USD). Large-scale implementation of these tests can lower the price even further, and the biggest benefit would be offering prompt treatment, with lower financial burden for both the patient and healthcare providers [ 7 , 206 ]. The reductions in the financial burden have been estimated by Hackshaw et al and Tafazzoli et al, showing that hypothetically MCED could reduce the cost per cancer treatment by up to 5421 USD per cancer patient [ 19 , 207 ].…”

“…It has been suggested that in breast cancer patients, six specific VOCs could be used for a screening test. Other studies have highlighted the importance of VOCs in cancers such as prostate, kidney, or lung [ 7 , 133 , 169 , 189 , 190 , 191 , 192 , 193 , 194 , 195 , 196 , 197 ].…”

The neglected potential of invertebrates in detecting disease via olfaction

“…Nevertheless, the use of animals naturally expressing specific behaviours toward healthy/sick samples should be further explored, as this could lead to rapid detection assays, avoiding a disadvantage of using conditioned individuals: the conditioning time (Figure 1). It is also important to note that this method is available for the public in Japan for a cost of ~100$ (di Luccio et al, 2022).…”